Provider Demographics
NPI:1861879892
Name:LOMA LINDA UNIVERSITY
Entity type:Organization
Organization Name:LOMA LINDA UNIVERSITY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY RESIDENCY PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMADA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:909-558-4000
Mailing Address - Street 1:11 TENNESSEE ST
Mailing Address - Street 2:APT #179
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-5420
Mailing Address - Country:US
Mailing Address - Phone:623-570-8787
Mailing Address - Fax:
Practice Address - Street 1:11 TENNESSEE ST
Practice Address - Street 2:APT #179
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5420
Practice Address - Country:US
Practice Address - Phone:623-570-8787
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72315183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty